Reactions 1348 - 23 Apr 2011

SCarbamazepine

Drug hypersensitivity in an elderly patient: casereport

A 72-year-old woman developed drug-inducedhypersensitivity syndrome during treatment withcarbamazepine.

The woman started receiving oral carbamazepine[Amizepin] 200mg three times daily for sensory axonalpolyneuropathy due to influenza virus vaccine inDecember 2009. On 4 January 2010, she was admittedfollowing the onset of a maculopapular rash over her entirebody and fever. On admission, she had elevated levels ofCRP and her ESR was high. Laboratory tests found signs ofliver cell damage, and a urine analysis revealederythrocyturia. A skin biopsy revealed chronicinflammatory infiltration in the layer of the dermis aroundthe vessels and around appendages, consisting mainly ofsmall lymphocytes, plasma cells, neutrophilicgranulocytes, small numbers of melanophages and a feweosinophils.

Carbamazepine was discontinued, and the womanreceived systemic corticosteroid and antihistamine therapywhich led to remission of the skin eruptions and thedisappearance of her general systemic symptoms.

Author comment: The timing of the onset of symptomsfollowing commencement of carbamazepine (at around 4weeks) is also characteristic, and would seem to corroboratethe presence of a cause-and-effect relationship with use ofthis drug, which is one of those most often responsible forthe occurrence of drug-induced hypersensitivity syndrome.Gomulka K, et al. Drug-induced hypersensitivity syndrome--a literature review andthe case report. Pneumonologia I Alergologia Polska 79: 52-6, No. 1, Jan 2011[Polish; summarised from a translation] - Poland 803053386

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Reactions 23 Apr 2011 No. 13480114-9954/10/1348-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved